Iridoschisis.
1967; BMJ; Volume: 51; Issue: 3 Linguagem: Inglês
10.1136/bjo.51.3.158
ISSN1468-2079
Autores Tópico(s)Congenital Anomalies and Fetal Surgery
ResumoSCHMITT (1922) was the first to describe a condition in which the iris stroma was split meridionally into two layers.The fibres of the anterior layer were ruptured and the unattached ends of these fibres floated free in the aqueous.Further cases were subsequently recorded by Drapkin (1923), Sander (1925( ), Vogt (1926)), Schoenberg (1927), Imre (1927), andDollfus (1927).Loewenstein and Foster (1945) presented the first histopathological study in describing one further case and proposed that the condition be termed "iridoschisis".Other examples of iridoschisis have since been described by Loewenstein, Foster, and Sledge (1948), Linn and Linn (1949), Garden and Wear (1949), McCulloch (1950), Blegvad (1951), Haik, Lyda, and Waugh (1952), Carter (1953), and Winstanley (1961).Seventeen cases have been traced in the literature, many in association with glaucoma (Table, overleaf).In others it was observed following trauma or chronic iridocyclitis.In several senile patients, apart from cataract, no associated ocular disease was evident.Four further examples of iridoschisis are described in the present communication, and the aetiology of the condition is discussed with particular reference to its associa- tion with glaucoma. Methods(1) Tonometry.-Exceptwhere stated in the case histories, the intra-ocular pressures were estimated by a weighted Schiotz tonometer.(2) Tonograplhy.-Powas determined by a Goldmann applanation tonometer affixed to a Haag-Streit "900" slit lamp.Ptl and Pt2 were determined at the beginning and end of a 4-minute period by direct scale readings taken from a Schwartzer electro-tonometer.No continuous recording device was available.The co-efficient of outflow (C) was determined by graphical construction, using a nomogram (Friedenwald, 1957) with correction for ocular rigidity.Po/C values were then calculated. Case ReportsCase 1, a boy aged 11 years, was struck in the left eye by a splinter of wood while chopping sticks on May 5, 1962.On examination a sectoral schisis of the left iris stroma was present inferiorly (Figure).The anterior lamina of iris had gravitated into the angle of the anterior chamber, but was still attached at the iris root.A comeal abrasion was present, and slit-lamp examination revealed a flare and cells (+ +).The fundus was normal, and no intra-orbital foreign body was seen on x ray.The uveitis rapidly resolved using atropine and chloramphenicol drops and oral penicillin V.When last seen on August 8, 1962, the zone of iridoschisis showed no change, and *
Referência(s)